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IEMbase 0287: GM2A-related GM2 activator protein deficiency

Scope

Field Value
IEMbase ID 287
Nosology 20.1.07.01
Gene GM2A
External IDs OMIM:272750; ORPHA:309246
Generated mapping MAPPED; Tay-Sachs_Disease_AB_Variant.yaml
Candidate DisMech targets Tay-Sachs_Disease_AB_Variant.yaml
Review date 2026-07-07

IEMbase phenotype signal

IEMbase represents GM2 gangliosidosis AB variant / hexosaminidase activator deficiency due to GM2A. Inheritance is autosomal recessive and treatability is unknown.

The clinical rows are sparse but neurologically focused: muscular hypotonia, psychiatric disturbances, spasticity, and urinary incontinence. Biochemical rows list normal-to-increased beta-hexosaminidase A activity and increased urinary oligosaccharides, consistent with a cofactor defect rather than a primary HEXA or HEXB catalytic-subunit deficiency.

DisMech phenotype coverage

Tay-Sachs_Disease_AB_Variant.yaml is the correct local target. The DisMech entry models GM2A loss, absence of the GM2 activator protein, preserved hexosaminidase A and B catalytic activity, failure of GM2 presentation to hexosaminidase A, and neuronal GM2 storage.

Local phenotypes include developmental regression, cherry-red spot of the macula, neurodegeneration, nystagmus, hypotonia, and hyperacusis. Local treatment coverage is supportive care. Genetic coverage correctly uses GM2A.

Concordance and completeness

Judgement: correct mapping to Tay-Sachs_Disease_AB_Variant.yaml.

IEMbase and DisMech agree on GM2A identity, autosomal recessive inheritance, a GM2 activator/cofactor defect, hypotonia, and the important distinction from HEXA/HEXB disease: beta-hexosaminidase catalytic activity is not the primary defect. DisMech is stronger for mechanism and classic neuro-ophthalmic phenotypes. IEMbase is thinner overall but adds spasticity, urinary incontinence, psychiatric disturbance, and urinary oligosaccharide rows as review prompts.

The normal-to-increased beta-hexosaminidase A row is especially useful because it helps distinguish AB variant disease from classic Tay-Sachs, where Hex A activity is decreased.

Curation actions

  • Keep this record mapped to Tay-Sachs_Disease_AB_Variant.yaml.
  • Consider adding an explicit biochemical/diagnostic row for preserved Hex A/B catalytic activity if supported by local evidence sources.
  • Review spasticity, urinary incontinence, psychiatric disturbance, and urinary oligosaccharides before importing them locally.